Health insurance companies such as Medicare Advantage, UnitedHealth, Humana, Elevance, Cigna, Blue Cross Blue Shield, Molina, UPMC offer coverage for hair prostheses. Various states such as Connecticut, California, Minnesota, Rhode Island, New Hampshire, New York, Florida, Maryland, Pennsylvania, Delaware, New Jersey and Delaware have laws in place which require health insurers to provide coverage for wigs or hair prostheses that are medically necessary.
Check your plan's coverage by accessing your member handbook or calling the number on the back of your card to ask about coverage for hair prostheses. Once you are aware of your plan's coverage limits, follow these steps for reimbursement:
1) Be enrolled in a qualified health plan.
2) After examination and diagnosis, request your health provider write a prescription for hair prosthesis due to medical necessity. Conditions such as Alopecia Areata, Alopecia Totalis and medical conditions which require radiation treatment and chemotherapy are examples of conditions that are usually covered. Loss of hair due to scalp or head injuries may also be covered.
3) Create an account and purchase your wig or custom prothesis at EssenceWigs.com. Please ensure that you provide head dimensions for custom wigs.
4) Retain and print your receipt by visiting your account section and accessing your order.
5) Before submitting a claim to your insurance, take photos of yourself from the neck up making sure your head and hair loss is showing. Submit your claim with your photos and prosthesis prescription to the claim submission portal of your health insurance. Be sure to explain that the wig purchase stems from medical necessity.
6.) Follow up with your insurer after claim submission to receive status updates. If your claim is denied, request to speak with a manager and resubmit.
7) If you are in need of help or verification of purchase of your hair prosthesis, Essence Wigs customer service is available to assist.
Required Coverage Limits by State
Delaware law requires all health insurers to cover up to $500 per calendar year for hair prostheses for individuals demonstrating medical necessity.
New Hampshire requires all health insurers to cover up to $350 per calendar year for hair prostheses that are medically necessary.
Connecticut requires all health insurers to provide coverage up to $350 for wigs needed due to hair loss from chemotherapy.
Maryland requires all health insurers to provide coverage up to $350 for (1) wig per calendar year for individuals experiencing hair loss due to medical conditions.
Minnesota requires all health insurers to provide coverage up to $1000 per benefit year for wigs which stem from medical necessity.
Missouri requires all health insurers to provide coverage up to $200 per calendar year or a one time expenditure of $3,200 for individuals experiencing hair loss due to medical conditions.
Rhode Island requires all health insurers to cover the cost of wigs or hair replacement in individuals experiencing hair loss due to medical conditions. Coverage is up to $350.
Florida requires all health insurers to cover hair replacement due to hair loss stemming from medical and health conditions. The law is effective January 1, 2025.
Massachusetts requires all health insurers to provide coverage up to $350 per benefit year for hair prostheses that are medically necessary.
New York requirers health insurers to provide coverage up to $750 for cranial prostheses to individuals demonstrating medical necessity.
Illinois will begin requiring health insurers to provide coverage of one wig every year for medical hair loss. The becomes effective January 1, 2026. The hair loss must stem from conditions such as alopecia areata, cancer, chemotherapy and radiation therapy.
New Jersey law requires health insurers to provide coverage for hair prostheses for a member once every 36 months.
Texas law requires health insurers to provide coverage for hair prostheses that costs over $100 and are medically necessary.
California now requires state regulated health insurers to provide coverage for hair prostheses for individuals experiencing temporary or permanent medical hair loss. This law went into effect in January 2025.
Pennsylvania requires health insurers to provide coverage for hair prostheses that are necessary due to medical hair loss. The coverage limit is $1,500.00.
Oklahoma requires health insurers to provide coverage for hair prostheses to individuals undergoing chemotherapy or radiation
Even if you are not located in one of these states, you can still check to verify whether your plan possesses coverage for hair replacements stemming from hair loss due to health or medical conditions. Experiencing hair loss can be a traumatic and stressful event. It helps for the hair loss sufferer to know that the costs associated with the purchase of necessary hair prostheses can be absorbed by medical insurance.
Essence Wigs
Note- The terms "cranial prosthesis" "hair replacements" "hair prostheses" refer to wig(s) and hair pieces
Visit us at www.essencewigs.com to view and purchase our wigs
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